Tuesday, September 15, 2009

Obama's statement that "I am not the first President to take up this cause, but I am determined to be the last." Whether or not he really thinks that, let's hope no one else supporting universal health insurance does. For even if the President should accomplish everything he said he wants in his speech, there are going to be people who are not covered - a lot of them. And regardless of what any Senator might say, single payer will be on the table until they are covered.

The President said: "There are those on the left who believe that the only way to fix the system is through a single payer system like Canada's," but he claimed that this "would represent a radical shift that would disrupt the health care most people currently have." Now, there are many things he might legitimately have said about the fight for a single payer system and the difficulty of achieving it. First off, there's nothing inherently shameful about compromise - it's a part of politics, just as it is a part of everyday life. What gives political compromise a bad name, however, is politicians claiming that a compromise between competing interests is not really a compromise at all, but a wonderful and better idea that they don't know why they hadn't thought of in the first place.

So Obama might legitimately have raised the point that there are powerful forces lined up against a single payer system, (and mentioned, if he wanted to be blunt, that the health insurance industry would go apoplectic - before going defunct.) And he could have spoken of how, if he were to seriously promote such a system, a lot of powerful people would turn their efforts to defeating him next time around and that they might even succeed, thereby jeopardizing other goals of his Administration. And it certainly would have been accurate to note that many people currently employed in the duplicative and wasteful private health insurance industry would no longer be needed and might have to be retrained for work in other fields, so their lives would be disrupted. (Provision for such retraining was actually written into the unsuccessful 1994 California single payer referendum.)

Unfortunately, Obama, who has in the past demonstrated a good understanding of what a single payer system would actually do, chose instead to make a statement he knows notjavascript:void(0) to be true. Such a system would not change "the health care most people currently have," but only the address where the health care provider would send the bill afterwards - just as many people whose bills are now sent to Medicare once had them paid by UnitedHealth or Aetna.